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foreign surgeons have multiple options of where theyamp;#39;re going to do surgery hospitals are competing for that volume and you know with the emergence of the ases you know I mean if youamp;#39;re not efficient thereamp;#39;s a lot of leakage thatamp;#39;s happening but how do you do that you need to look at how youamp;#39;re using your or today in a thoughtful way and like align it to the search and practice patterns go there have conversation with their surgeons I thereamp;#39;s so many times that Iamp;#39;ve gone to a surgeons Clinic had a conversation with their Clinic manager and theyamp;#39;ll tell me well weamp;#39;re hiring another surgeon of September and I go back to the hospital and say did you know that I donamp;#39;t know really well how do you anticipate that youamp;#39;re going to support this new surgeon theyamp;#39;re going to bring aboard if the surgeon has better access at the ASC thatamp;#39;s where the surgeons doing the surgeries there are certain